Maternal Mortality Ratio Declining in India – good news about “Good News”

This article is celebrating declining maternal mortality in India indicating success of government efforts. It also discusses about MMR (Maternal Mortality Ratio), what its current trends are, what future targets are, what the causes of high MMR are, and what efforts are in force to improve it.

Introduction

Maternal Mortality Ratio

Key Statistics

Causes of High Maternal Mortality

Efforts of Government

Future Goals

Conclusion

Introduction

Maternal mortality or maternal death refers to death of a woman due to pregnancy, delivery or death within a period of 42 days after delivery of a baby as a result of any complication arising from pregnancy. It is measured by MMR which is abbreviated Maternal Mortality Ratio.

Maternal Mortality Ratio

Maternal Mortality Ratio is an important indicator of health. According to WHO, MMR is defined as number of deaths of women per 100000 live births. It is different from Maternal Mortality Rate which is defined as the number of deaths of pregnant women in the reproductive age group.

Key Statistics

As per the latest report of Sample Registration Survey of 2015-2017, MMR (Maternal Mortality Ratio) in India is 68% in the age group of 20-29 years. It means that most of the maternal deaths are concentrated in the age of 20s. The most celebrated finding of this report is that MMR in India has declined by 6.2%. In last report of Sample Registration Survey (2014-2016), MMR was 130 and now it has dropped to 122. It is even appreciated by WHO (World Health Organization). Maternal Mortality Ratio in India has declined consistently since last three decades. In 1990s, it was high even more than 200 in many states.

Sample Registration Survey has divided states in to three categories on the basis of their performance.

Best States

All southern state and Maharashtra fall in this category. The top performing states are Kerala, Maharashtra and Karnataka with Maternal Mortality Ratio of 42, 55 and 63 respectively.  

Empowered Action Group

The group includes the worst performing states like Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Uttar Pradesh, Odisha, Rajasthan, Uttarakhand.

Average States

Rest of the states and union territories fall in this category.

Causes of High Maternal Mortality

The biggest cause of high maternal deaths in developing countries is lack of resources. The following factors contribute to trigger this number:

Family Culture

Due to lack of awareness, families are not aware about complications associated with pregnancy. Neither they know, nor do they try to attain necessary information. Women prefer deliveries at home instead of institutional deliveries, thus unable to get the medical assistance from professionals during delivery of baby.  

Delay in Reaching Health Care Facility

Lack of transportation facilities, bad conditions of roads in rural areas and distant remote areas, lack of access to vehicles, it becomes difficult for women to reach the health care premises at right time.    

Inefficient Treatment in Hospitals

Non availability of adequate infrastructure, poor maintenance and lack of health care staff are also responsible factors for high maternal mortality ratio.

Poverty

On account of being poor, pregnant women from poor families do not get adequate nutrition. If a woman is a wage labour then it becomes even more difficult. She has to work for daily wage also along with routine household work. If she is not able to work, she has to face financial crisis.

Thus, overall poverty, unawareness, cultural practices and beliefs, non adherence to sanitation and hygienic practices and norms, distance from health care facility and poor quality of health care services are the key augmenting factors for high maternal mortality. Apart from institutional flaws, social and economic issues, the medical complications like high blood pressure due to pregnancy, infections, unsafe abortions, excessive bleeding and post partum haemorrhage are also responsible for high MMR.

Efforts of Government

The government of India is taking sincere efforts to slowdown maternal mortality in the country. The programs being run in this direction provide conditional cash transfer, nutritional support, emphasize sanitation standards, ensure natal and prenatal care. These efforts are reflected in various maternal and infant care schemes like Lakshay, Poshan abhiyan, Pradhan Mantri Surakshit Matritva abhiyan, Janani Shishu Suraksha Karyakram, Janani Suraksha Yojna, Pradhan Mantri Matra Vandana Yojna. The most recent program is SUMAN which is Surakshit Matritva, Ashwasan Initiative. The key objective of SUMAN is to ensure not even a single mother or infant dies die to a preventable cause.

Future Goals

National Health Policy has set a target to lower maternal mortality ratio to less than 100 by 2020. This target is designed by considering Sustainable Development Goal number 3.1 which is to bring down MMR to a level of less than 70 by 2030.

Conclusion

This target of reducing MMR to below 100 under national health policy has already been achieved in eleven states due to past efforts of government. The existing challenge in achieving this target is lack of institutional deliveries. More efforts in infrastructure, health care are also required to be put in force by respective state governments of worst performing states in addition to the existing mother care programs.

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